Dermatology skin care an overview for a medical student

1. SKIN CARE
TREATMENT

2. DEFINITION:
A topical medication is one that is applied to body
surfaces such as skin or mucous membranes.
ADVANTAGES:
Achieve high concentration of drug in skin.
Minimal exposure to other organs.
TOPICAL THERAPY

3. TOPICAL THERAPY
• Stratum corneum is the rate limiting barrier to
percutaneous drug delivery.
• Drug penetration is inversely proportional to the
thickness of stratum corneum .

4. ABSORPTION
• transcellular penetration
(across the cells)
• intercellular penetration
(between the cells)
• Trans appenda-geal penetration
(via hair follicles , sweat and
sebaceous glands and pilo-
sebaceous apparatus)

5.  The vehicle or the formulation
 Concentration of drug
 Frequency of application
 Quantity to be use
 Site of application
 Precise timing of application

6. VEHICLE
Vehicle include all the constituents of formulation apart from
active ingredients.
Ideal vehicle / base : non toxic, non allergic, non irritant, stable,
chemically inert, cosmetically acceptable , should not inactivate the
drug .
Vehicles have non specific beneficial therapeutic effects like
occlusion, hydration, cooling, soothing, astringent action.
They form the reservoir of active agent .
Vehicles include ointment , cream , gel , lotion etc.

7. Choice of vehicle
depends on
• Anatomical site to be
treated (scalp, face)
• Skin condition to be
treated (dry,
exudative)

8. Mixture of finely divided drugs and/or chemicals in dry form.
Cooling effect
Prevents friction
Absorbs moisture
Covering property
Generally used in intertriginous areas and on feet.
Adverse effects - caking, crusting, irritation, inhalation by the user.
POWDER

9. Powders are of two types:
Organic
Inorganic
Organic powders include starch, zinc/magnesium stearate.
Inorganic powders include ZnO, titanium oxide, calamine,
talc etc.
• Insoluble powder should not be dusted into open wounds
• Previous application should be washed off

10. OINTMENTS
They are semisolid, petrolatum based vehicles capable of providing
occlusion, hydration and lubrication.
Advantages:
• Provides best occlusion
• Good hydration
• Used in chronic, dry, brittle, lichenified dermatoses.
• Most potent effect of the drug.
• Fewer preservatives are required as they contain less water and do not
sustain microorganisms.

11. Disadvantages:
• Difficult to spread and wash.
• Adherent to skin
• Decreased evaporation/heat loss.
• Cannot be used in acute weeping lesions and
intertriginous areas.

12. Ointment bases can be classified into 5 categories:
 Hydrocarbon bases
 Absorption bases
 Emulsion of water in oil
 Emulsion of oil in water
 Water soluble bases

13. EMULSIONS
Emulsions are two phase systems involving one or more
immiscible liquid dispersed in another, with the assistance of
one or more emulsifying agents.
Emulsifier is soluble in both phases and surrounds the
dispersed drops to prevent coalescence.
Preservatives added to increase shelf life.
Two types:
1. Oil in water emulsion 2. Water in oil emulsion

14. GELS
Made from water soluble bases by formulating water ,
propylene glycol and / or polyethylene glycol with a
cellulose derivative or carbopol.

15. ANTI - INFECTIVES
Anti-infectives is a general term used to describe any
medicine that is capable of inhibiting the spread of an
infectious organism or by killing the infectious organism
outright.
This term encompasses antibiotics, antifungals,
anthelmintic, antimalarial, antiprotozoal, anti-tuberculosis
agents, and antivirals

16. Antifungal medicines are used to treat fungal infections,
which most commonly affect your skin, hair and nails.
Infections antifungals can treat
Fungal infections commonly treated with antifungals include:
• ringworm
• athlete's foot
• fungal nail infection
• vaginal thrush
ANTI - FUNGAL

17. Common names for antifungal medicines include:
• clotrimazole
• econazole
• miconazole
• terbinafine
• fluconazol

18. Antiviral drugs
Common antiviral agents include acyclovir (Zovirax),
famciclovir (Famvir), and valacyclovir (Valtrex). Antiviral
treatments are used for skin conditions including those
related to herpes and shingles
Antiviral drugs

20. PUVA THERAPY
PUVATherapy, or photo chemotherapy, to treat some of the
most severe skin diseases with optimal results.
PUVA, also called photo chemotherapy, is a form of ultraviolet
radiation treatment used for serious skin diseases.
The P stands for psoralen, a type of chemical found in certain
plants, and the UVA stands for ultravioletA, a long wave
ultraviolet radiation

21. The oral administration of the psoralens is followed by UVA
light exposure, which activates the psoralens, causing them to
interact with the body’s DNA, thus inhibiting the cell
multiplication of certain skin diseases.

22. Who is a Candidate for This Treatment ?
Originally developed for treatment of psoriasis,
PUVA treatment is also used on patients with other chronic
skin diseases including graft versus host disease, cutaneous
T cell lymphoma and vitiglio.

23. What is the Advantage of PUVA ?
PUVA is able to activate only at the site of the disease,
on the skin, making it less toxic than similar therapies
that require systemic administration and have effects
on other parts of the body.

24. A number of side effects are associate with PUVA, including:
Are There Side Effects?
Headache and dizziness
Nausea
Itching and redness
Skin burn and blistering
Tanning or darkening of the skin

25. What Can I Expect After Treatment?
After treatment, skin should be checked by a physician at
least once or twice a year for skin cancer or signs of other
damage.

26. Who is a Candidate for
This Treatment
These diseases are characterized by rapidly multiplying cells
and the goal of PUVA therapy is to arrest the multiplication.
Because of its serious side effects, the therapy is not
generally recommended for children.
Care should be taken with patients who have had
melanoma or multiple skin cancers, are pregnant or
nursing, or who have skin types that tend to burn easily.